ABSTRACT
Objective: Three dimensional X-ray imaging by Volume RAD, familiar with the operation method, a reasonable set of parametersin time, improve the technology efficiency at the same time, the control of possible ways to reduce the radiation dose. Methods: The 168 cases of patients with Volume RAD examination were divided into low, middle, high dose group, dose ratio was 5:10:15; respectively to examine patient’s chest, head, cervical spine, pelvis and knee joints, observe its effect. To track acquisition and scanning sampling, analyze of experiment and the effect. Results:The experimental results show, small lung nodules and trabecular bone dose, high dose group in the image quality is better than the dose than the low dose group, the display image quality, no significant difference between the 3 groups. Conclusion:After a time exposure capture can be parallel to the image surface of the detector series, was displayed in thecomplex structure and the overlapping parts of the details. But its operations are complex, need the exposure dose on dozens of times, how to control the exposure time and dose, which needs further research to select the best dose control scheme.
ABSTRACT
ObjectiveTo discuss the clinical experience and influence factors of airway complications after lung transplantation for end-stage lung diseases through reviewed 28 lung transplantation cases in our center.MethodsFrom August 2005 to December 2010,28 patients with end-stage lung diseases received lung transplantations consecutively in our center,in which 13 patients were bilateral-lung transplantation(BLT) and 15 patients were single-lung transplantation(SLT).The donor lungs were perfused with LPD solution antegrade and retrograde followed.During operation,the pulmonary artery pressure and flow rate were tested real time through the transesophageal echocardiography and Swans catheter.Postoperative care of patients was in respiratory intensive care unit,and immunosuppressive drugs were adjusted according to blood drug concentration.ResultsThere were no airway complications including anastomotic fistula or stenosis found in all patients.The mortality was 7.2% in the early postoperative period ( 1-30 days).Cumulative survival rate was 94.1% % at 1 year,76.2% at 2 years,and 71.4% at 3 years respectively.Four patients (14.3%) died in the postoperative 90 days.Three patients were reanastomosed pulmonary artery in operation because of stenosis detected by transesophageal echocardiography.After operation,three patients were reoperated,in which two were bleeding and one was pulmonary bulla and pneumothorax.All patients were followed from 1 year to 6.1 years after operation.The quality of life was improved significantly.ConclusionThe well improved technique of lung transplantation is helpful to reduce the operation related complications,decrease the early mortality post operation and play the important role in the effects of quality of life and long term survival rate.The intraoperative transesophageal echocardiography examination could detect the anomalous situation of vascular anastomosis.At the same time the patients should get benefits from the routine and close follow-up.
ABSTRACT
Minimally invasive surgery is commonly used in a range of orthopedic fields with many surgeons employing minimally invasive techniques for total hip arthroplasty. Some surgeons, however, have recently suggested that the term 'mini-incision' is more correct than 'minimally invasive'. Many studies have reported the increased malposition of implants and complications, such as dislocations and nerve injury, in minimally invasive surgery due to the compromised visualization of the surgical field. Patient selection with the proper indications is of utmost importance for the success of minimally invasive total hip arthroplasty. In addition, selection of the correct surgical technique is essential. Furthermore, the procedure should be performed by an experienced surgeon with the appropriate surgical instruments.
Subject(s)
Arthroplasty , Joint Dislocations , Hip , Orthopedics , Patient Selection , Surgical InstrumentsABSTRACT
Recently the interest in minimal invasive surgery for total hip arthroplasty is increasing due to its advantages of less soft tissue injury, less postoperative pain, early rehabilitation and cosmesis. There are two methods of minimal invasive surgery for total hip arthroplasty; one incision and two incision technique. The more common method is the one incision technique and among them, anterolateral and posterior or posterlateral method are most common. This one incision method reduces the length of incision. Two incision method was developed by Mears and Berger to reduce the degree of trauma to the muscles and tendons as well as to reduce the incision size. But the minimal invasive total hip arthroplasty has some potency of development of complications due to smaller operation field. So the minimal invasive total hip arthroplasty should be done only by experienced surgeons with sufficient training and adequate equiments.
Subject(s)
Arthroplasty , Hip , Muscles , Pain, Postoperative , Soft Tissue Injuries , TendonsABSTRACT
With changing mechanisms of injury, heightened clinical awareness, and better diagnostic technology, odontoid fractures constitute 9~18% of cervical fractures in recent reports. The odontoid type II fracture is the most common axis fracture and it is also the most difficult to treat. Type II fractures with greater than 6mm dens dislocation have a higher incidence of nonunion with nonoperative therapy and should be offered early operative reduction with fusion. Recently we have experienced a young male patient with odontoid type II fracture. The degree of dens dislocation was 8mm. The fractured odontoid process was removed through transoral-transpharyngeal approach and bone fusion was performed with iliac bone. And the inserted bone was fixed with screws and mini-plate for further stabilization. The operative result was good without any serious complications. The operation technique is detailed.
Subject(s)
Humans , Male , Axis, Cervical Vertebra , Joint Dislocations , Incidence , Odontoid ProcessABSTRACT
Basilar invagination or basilar impression involves the upward displacement of the margins of the foramen magnum into the base of the skull. That this entity may be asymptomatic or associated with symptoms referable to encroachment into the posterior fossa or embarrassment of the posterior circulation is well known. Currently the authors have experienced a young male patient with basilar invagination presented with progressive myelopathy and lower cranial neuropathies due to odontoid invagination. It was thought that a posterior decompression would be hazardous;therefore, the inferior clivus, odontoid process, and anterior arch of the atlas were removed transoral-transpharyngeally and bone fusion was performed with iliac bone. Furthermore the operative result was good without any serious complication. The operation technique is detailed.